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Healthfirst Sr Healthcare Analyst - Risk Model Analytics in New York, New York

Please note: Since we care so greatly about our employees' and members' wellbeing, Healthfirst is moving to a fully vaccinated in-office environment. You must be vaccinated to work in our offices, even if you are partially remote. If you are selected to interview for this role, we will explain our vaccination policy and ensure you are comfortable moving forward with further interviews based on your work location.

Hello! Thank you for considering Healthfirst for your next career opportunity.

Who we are:

Healthfirst was founded by a collection of major healthcare systems in the New York area to emphasize high quality of care, and better patient outcomes. We have grown into New York’s largest not-for-profit health insurer and cover over 1.7 million members in New York City and on Long Island, as well as in Westchester, Sullivan, Orange, and Rockland counties. Healthfirst accomplishes this all while following our value-based model and collaborating with our hospital sponsors and provider partners through our provider delivery system.

More about the team, and the role:

Within the larger Finance department, the Hospital Risk Analytics team monitors performance and identifies opportunities for improvement for our sponsor hospitals within our value-based risk model. The Senior Healthcare Analyst is responsible for monitoring risk pool performance, transforming large, complex datasets into actionable insights, and partnering with our Network team to communicate financial results to Healthfirst and hospital leadership. This role will have the opportunity to contribute to a broad set of projects across departments and is ideal for someone who is interested in value-based payment models and enjoys working in a fast-paced and challenging environment.

You will:

  • Produce and manage performance reports of value-based risk share agreements

  • Monitor costs and revenue trends for healthcare providers and identify root cause of developing trends

  • Understand and analyze impacts of new program changes such as new benefits or new populations

  • Prepare monthly analyses for analytic council meetings and stakeholders. Respond to requests for analysis and provide analytic support to various stakeholders and departments

  • Pull data from warehouse using Structured Query Language (SQL) code/Python (or similar programs) and build reports and dashboards in Tableau or Excel

  • Manage and organize meetings to discuss analysis requests and clearly communicate trends and results to appropriate stakeholders

  • Keep abreast of changes in our provider community, as well as New York Medicaid and Medicare reforms and their impact on the health plan and owner hospital performance

Minimum Qualifications:

  • Bachelor's degree from an accredited institution

  • Current or previous work experience within a Hospital, Healthcare or Managed Care organization

  • Experience in conducting medical cost and revenue analyses using claims and other data sources

  • Experience in managing projects across multiple departments

  • Work experience with Microsoft Excel -create pivot tables, formatting, sorting, create spreadsheets with complex formulas such as sum products, Vlookups

  • Experience with SQL and creating and developing new reports that can be used for analysis

  • Skilled in data manipulation, database software, spreadsheets, and analytical software including SQL and Tableau

Preferred Qualifications:

  • Demonstrated understanding of key managed care concepts and provider reimbursement principles such as risk adjustment, capitation, FFS (Fee-for-Service) and other payment mechanisms.

  • Experience in supporting Network Management analytical requests.

  • Self-motivated, creative problem solver who can work independently and collaborate through strong communication and interpersonal skills.

  • Strong project management experience and ability to handle multiple projects in a fast-paced environment.

  • Experience in modeling financial impact of provider reimbursement changes.

WE ARE AN EQUAL OPPORTUNITY EMPLOYER. Applicants and employees are considered for positions and are evaluated without regard to race, color, religion, gender, gender identity, sexual orientation, national origin, age, genetic information, military or veteran status, marital status, mental or physical disability or any other protected Federal, State/Province or Local status unrelated to the performance of the work involved.

If you have a disability under the Americans with Disability Act or a similar law and want a reasonable accommodation to assist with your job search or application for employment, please contact us by sending an email to careers@Healthfirst.org or calling 212-519-1798 . In your email please include a description of the accommodation you are requesting and a description of the position for which you are applying. Only reasonable accommodation requests related to applying for a position within Healthfirst Management Services will be reviewed at the e-mail address and phone number supplied. Thank you for considering a career with Healthfirst Management Services.

EEO Law Poster and Supplement (http://www.dol.gov/agencies/ofccp/posters)

All hiring and recruitment at Healthfirst is transacted with a valid “@healthfirst.org” email address only or from a recruitment firm representing our Company. Any recruitment firm representing Healthfirst will readily provide you with the name and contact information of the recruiting professional representing the opportunity you are inquiring about. If you receive a communication from a sender whose domain is not @healthfirst.org, or not one of our recruitment partners, please be aware that those communications are not coming from or authorized by Healthfirst. Healthfirst will never ask you for money during the recruitment or onboarding process.

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